New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

Gilead Sciences Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for Gilead Sciences Gilead Sciences, a leading biopharmaceutical company known for its innovative therapies, typically partners with various healthcare providers and networks to facilitate patient access to its medicines. Specific details about Gilead's healthcare providers can vary by region and therapeutic area, but they often collaborate with hospitals, specialty clinics, pharmacies, and physicians nationwide to ensure effective treatment and management of diseases, particularly in areas like HIV, oncology, and liver diseases. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are anticipated to rise significantly due to a combination of factors affecting the Affordable Care Act (ACA) marketplace. With some states projecting premium increases of over 60%, the expiration of enhanced federal subsidies could lead to over 22 million enrollees experiencing out-of-pocket premium spikes exceeding 75%. Contributing to these increases are escalating medical costs driven by inflation, higher utilization of healthcare services, and record profitability reported by major insurers, which are amplifying price pressures on consumers seeking affordable healthcare solutions. Click here to learn more

'Gilead Sciences employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Gilead Sciences employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
Practical steps Gilead Sciences professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. ¹

“It feels like a second mortgage to pay this premium.”

Profile: A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed: Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure: They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response: We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile: A single client in her early 60s undergoing ongoing medical treatment.

What changed: Without enhanced subsidies, her premiums nearly tripled.

Decision pressure: Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response: We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile: A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed: Without subsidies, their net premiums are expected to rise sharply.

Decision pressure: Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response: We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile: An independent contractor in their 20s with minimal expected medical use.

What changed: Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure: Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response: We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. ²

How The Retirement Group Supports Gilead Sciences Professionals

For Gilead Sciences employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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Sources:

1. Cox, Cynthia, et al. “ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Expire.” Kaiser Family Foundation (KFF) , 2025, pp. n.p., https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/ .
2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
Other resources:
1. “When Can You Get Health Insurance? | Dates & Deadlines.” HealthCare.gov , U.S. Centers for Medicare & Medicaid Services, n.d., https://www.healthcare.gov/quick-guide/dates-and-deadlines/ .
2. Publication 969: Health Savings Accounts and Other Tax-Favoured Health Plans. Internal Revenue Service, 2024, pp. 8–9, https://www.irs.gov/pub/irs-pdf/p969.pdf .
3. “Silver vs. Bronze Plan Selection: Cost-Comparison Scenarios.” Centers for Medicare & Medicaid Services (CMS) , 23 Dec. 2024, pp. 1–3, https://www.cms.gov/files/document/silver-vs-bronze-cost-comparison-scenario-resource.pdf .
4. Murphy, Tom. “Expect Health Insurance Prices to Rise Next Year, Brokers Say.” AP News , Associated Press, 24 Aug. 2025, https://apnews.com/article/health-insurance-drug-costs-2026-rates-c4d865ec09c7088ecc6b55dc520f3566 .

How does Gilead's approach to employee benefits evolve to ensure comprehensive health coverage for full-time and part-time employees, and how do these benefits align with industry standards? Additionally, considering the competitive landscape, what specific initiatives does Gilead undertake to maintain and enhance its health benefits offering?

Gilead ensures comprehensive health coverage for both full-time and part-time employees by offering competitive medical, dental, and vision plans. Full-time employees, as well as part-time employees working at least 30 hours a week, are eligible for a range of health benefits, including coverage for spouses, domestic partners, and dependent children. This benefits package includes life and disability insurance, health savings accounts, and wellness services such as biometric screenings and fitness reimbursements, aligning with industry standards(Gilead_2016_Company_Peo…).

In what ways does Gilead's professional development program contribute to the personal and career growth of its employees? How does Gilead gauge the effectiveness of these development initiatives, and what feedback mechanisms are in place to continually improve the offerings?

Gilead’s professional development program contributes to employees' personal and career growth through extensive training opportunities, leadership development programs, and an MBA program in partnership with Golden Gate University. Gilead monitors the effectiveness of these initiatives through completion metrics, feedback surveys, and by tracking career progression. A continuous feedback loop ensures that employee development programs evolve based on participants’ experiences and business needs(Gilead_2016_Company_Peo…).

Gilead emphasizes a pay-for-performance model in its compensation structure. How does this model operate in practice, and in what ways are performance metrics tied to employee compensation at Gilead? Moreover, how does the company ensure transparency and fairness in its pay practices?

Gilead operates a pay-for-performance model, where employee compensation is directly tied to individual performance evaluations and business results. Regular reviews ensure that compensation remains fair and competitive, with transparency maintained through structured performance assessments. Gilead promotes pay equity, regularly reviewing compensation practices to ensure fairness and alignment with market conditions(Gilead_2016_Company_Peo…).

Given the unique challenges associated with employee parental leave, how does Gilead support employees who are navigating this transition? Furthermore, how are Gilead's policies aligned with or surpassing industry standards regarding parental leave and adoption benefits?

Gilead supports employees during parental leave transitions by offering 12 weeks of paid leave for new parents in the U.S., along with adoption benefits and reimbursements of up to $5,000. This benefit, extended to both U.S. and international employees, ensures legislative compliance and alignment with market standards, often surpassing industry norms(Gilead_2016_Company_Peo…).

With the increasing importance of mental health support in the workplace, how does Gilead's Employee Assistance Program (EAP) address the diverse wellness needs of its employees? In what ways does Gilead promote the utilization of these services to ensure engagement and effectiveness?

Gilead’s Employee Assistance Program (EAP) addresses a broad range of wellness needs, including mental health support, counseling, and legal or financial assistance. The company promotes these services through internal communications and wellness campaigns, ensuring employees are aware of and engage with these offerings, which are designed to provide confidential and comprehensive support(Gilead_2016_Company_Peo…).

How does Gilead foster an inclusive work environment that values diversity? What specific programs and initiatives are in place to promote inclusion, and how does Gilead measure the success of these diversity initiatives?

Gilead fosters an inclusive work environment through Employee Resource Groups (ERGs) and diversity initiatives aimed at professional development and community engagement. The company measures the success of its inclusion efforts through employee feedback, participation in diversity programs, and performance management processes that now include “inclusion” as a core value(Gilead_2016_Company_Peo…).

Considering Gilead's Employee Stock Purchase Program (ESPP), how do the company's policies encourage employee investment in Gilead? What benefits do employees gain from participating in the ESPP, and how does it contribute to their overall financial well-being?

Gilead’s Employee Stock Purchase Program (ESPP) encourages investment by offering U.S. employees the ability to contribute 1-15% of their pay to purchase Gilead stock at a 15% discount. This program helps employees build financial security and aligns their interests with the company's success, contributing to overall financial well-being(Gilead_2016_Company_Peo…).

What role does volunteerism play within Gilead's corporate culture, and how does the company facilitate employee engagement in community service initiatives? Additionally, how does participation in these programs impact employee satisfaction and retention rates?

Volunteerism is integral to Gilead’s corporate culture, with the company supporting employee involvement in community service through its Gilead Volunteer Community. These activities align with Gilead’s mission and values, and participation positively impacts employee satisfaction and retention by fostering a sense of purpose and community engagement(Gilead_2016_Company_Peo…).

How does Gilead ensure that its benefits package remains competitive within the biotechnology industry? What strategies does Gilead employ to regularly assess and enhance its offerings to meet the evolving needs of its workforce?

Gilead ensures its benefits package remains competitive by regularly reviewing and benchmarking against industry standards. The company adjusts offerings to meet evolving employee needs, particularly in areas like health and wellness, retirement plans, and work-life balance, ensuring that its benefits are both market-competitive and supportive of long-term employee well-being(Gilead_2016_Company_Peo…).

For employees seeking more information about Gilead's benefits and retirement options, what are the best channels to contact Gilead? How does Gilead ensure that employees have access to clear and timely information regarding their benefits, and what resources are available to assist them during the retirement process?

Employees seeking more information about Gilead’s benefits and retirement options can access resources through the company’s HR portals, internal communication channels, or by contacting HR directly. Gilead provides clear, timely information and offers comprehensive resources such as retirement planning consultations and financial wellness programs to assist employees during the retirement process(Gilead_2016_Company_Peo…).

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.

Name of Pension Plan: Gilead Sciences does not appear to have a traditional defined benefit pension plan as of the latest information for 2022, 2023, and 2024. Instead, the company emphasizes its 401(k) plan as a primary retirement benefit. Pension Formula and Qualification: Since there is no traditional defined benefit pension plan, there are no specific formulas or age/service qualifications related to a pension plan. Name of 401(k) Plan: Gilead Sciences 401(k) Plan 401(k) Plan Eligibility: Employees are eligible to participate in the Gilead Sciences 401(k) Plan upon meeting certain criteria, including a minimum period of employment which is typically 30 days. Contribution Details: Gilead Sciences offers a matching contribution to the 401(k) Plan, with the company matching a percentage of employee contributions up to a specific limit.

Restructuring and Layoffs: In 2023, Gilead Sciences announced a significant restructuring plan aimed at optimizing its operational efficiency. This included a reduction of approximately 5% of its workforce. The company stated that these changes were part of a broader strategy to streamline operations and better position itself for long-term growth amidst evolving market conditions. Source: Business Insider. Importance: Given the current economic volatility and changes in the investment landscape, understanding these developments is crucial for stakeholders to assess the impact on company performance and stability. The restructuring is also relevant due to its potential effects on employee benefits and overall corporate strategy.

Gilead Sciences Stock Options and RSUs Stock Options and RSUs Overview: Gilead Sciences has offered stock options and Restricted Stock Units (RSUs) as part of its compensation package. For Gilead Sciences, stock options are typically granted to executives and key employees based on individual performance and company goals. RSUs at Gilead Sciences are generally awarded to a broader range of employees, including those in key roles, to align their interests with shareholder value.

1. Company Official Website Gilead Sciences Official Website: Gilead Sciences Benefits Summary: Gilead Sciences offers a comprehensive benefits package including medical, dental, and vision coverage. They provide options for both HMO and PPO plans, and there are additional wellness programs and resources for employees. 2. Glassdoor Gilead Sciences on Glassdoor: Glassdoor - Gilead Sciences Benefits Summary: Employees on Glassdoor report strong health benefits including generous health insurance coverage, wellness programs, and an Employee Assistance Program (EAP). The company also offers flexible spending accounts (FSAs) and health savings accounts (HSAs). 3. Indeed Gilead Sciences on Indeed: Indeed - Gilead Sciences Benefits Summary: Indeed highlights that Gilead Sciences provides extensive healthcare benefits including medical, dental, and vision insurance, with coverage options for family members. Employees appreciate the company's focus on health and wellness. 4. Employee Benefits News Employee Benefits News - Gilead Sciences: Employee Benefits News Summary: Recent news indicates that Gilead Sciences has been updating its benefits packages to include more mental health support and telemedicine services. They are also expanding their wellness programs to address holistic health needs. 5. HR Dive HR Dive - Gilead Sciences Benefits: HR Dive Summary: HR Dive reports that Gilead Sciences has introduced new benefits in response to the evolving healthcare landscape. This includes enhanced telehealth options and increased coverage for mental health services.

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